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Suicide Risk Assessments Understood as Medical Rituals: Functions and Implications from Societal and Medico-Ethical

Antoinette Lundahl1

  • 1Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden. antoinette.lundahl@ki.se.

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|June 3, 2025
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Summary

Suicide risk assessments in psychiatric care are ritualistic, not clinically effective. Their continued use may harm patients, necessitating evidence-based interventions like safety plans and proper mental health treatment.

Keywords:
Medical ethicsRitualsSuicide preventionSuicide risk assessments

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Area of Science:

  • Psychiatry
  • Medical Sociology
  • Bioethics

Background:

  • Suicide risk assessments are standard in psychiatric treatment.
  • These assessments have poor predictive accuracy and limited clinical utility.

Purpose of the Study:

  • To analyze non-medical reasons for the continued use of suicide risk assessments.
  • To interpret suicide risk assessments as medical rituals fulfilling social functions.

Main Methods:

  • Qualitative analysis of suicide risk assessments as medical rituals.
  • Examination of proposed social functions and potential negative consequences.

Main Results:

  • Suicide risk assessments serve social functions: uniting providers, creating perceived safety, projecting accountability, and signaling public action.
  • Potential harms include increased compulsory admissions, flawed patient prioritization, and defensive medicine.

Conclusions:

  • Ritualistic use of suicide risk assessments is ethically indefensible due to patient harm.
  • Recommends evidence-based interventions: general safety measures, patient safety plans, and needs-based mental health treatment.